CTICasesHypoattenuating Leaflet Thickening
Imaging findings
Four-dimensional cardiac CT in a patient post-TAVR with an elevated transvalvular gradient demonstrates hypo-attenuating leaflet thickening (HALT) involving all three prosthetic leaflets, with associated hypo-attenuating leaflet motion restriction (HAM). The thickening and restricted motion resolved completely following therapeutic anticoagulation with warfarin.
Key takeaways
Hypoattenuating leaflet thickening (HALT) and hypoattenuating leaflet motion restriction (HAM) are key imaging signs of subclinical leaflet thrombosis following transcatheter aortic valve replacement (TAVR). This is caused by thrombus formation on the prosthetic leaflets. It is a recognized cause of increased gradients post-TAVR and typically responds well to anticoagulation, preventing valve failure.
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